AM DC Rogaška, Department of Gastroenterology, Rogaška Slatina.
National Institute for Public Health, Department SVIT, Ljubljana.
Eur J Cancer Prev. 2021 Jul 1;30(4):304-310. doi: 10.1097/CEJ.0000000000000628.
We aimed to assess the impact of the first three rounds of the National Colorectal Cancer Screening Program (NCCSP) on CRC incidence and mortality in Slovenia. In NCCSP, we use two fecal immune tests (FITs) and if test is positive patient is referred to colonoscopy. From 2009, we invite Slovenian residents aged 50-69 years, one screening round takes 2 years. The response rate was from 56.9 to 59.9%. FIT was positive in 6.0-6.2% (more in older patients and in men; P < 0.05). The adenoma detection rate was >51.3% (more in men; P < 0.01). In NCCSP, 70.3% of all cancers diagnosed were in stages I and II, while 20.7% of all CRC were found in polyps resected during colonoscopies. Patients with positive first FIT have odds ratio 2.19 [95% confidence interval (CI), 2.06-2.32] for advanced neoplasia and cancer compared to patients with two negative FITs. The incidence rate for CRC has dropped significantly after 6 years in population and in men (P < 0.01) but not in women. Five-year CRC survival was 31.3% higher if cancer was diagnosed in NCCSP (P < 0.05). After 6 years of NCCSP, the incidence rate for CRC has dropped significantly (P < 0.01). Hazard ratio for death from CRC was 3.84 higher (95% CI, 3.36-4.40; P < 0.001) in patients with cancer detected outside the program.
我们旨在评估斯洛文尼亚国家结直肠癌筛查计划（NCCSP）前三轮对 CRC 发病率和死亡率的影响。在 NCCSP 中，我们使用两种粪便免疫测试（FIT），如果测试呈阳性，患者将被转介至结肠镜检查。从 2009 年开始，我们邀请 50-69 岁的斯洛文尼亚居民参加，一轮筛查持续 2 年。响应率为 56.9%至 59.9%。FIT 呈阳性的比例为 6.0-6.2%（年龄较大的患者和男性中更高；P<0.05）。腺瘤检出率>51.3%（男性中更高；P<0.01）。在 NCCSP 中，诊断出的所有癌症中 70.3%处于 I 期和 II 期，而所有 CRC 中有 20.7%是在结肠镜检查中切除的息肉中发现的。与两次 FIT 均为阴性的患者相比，首次 FIT 阳性的患者患有晚期肿瘤和癌症的优势比为 2.19（95%置信区间，2.06-2.32）。在人群和男性中，NCCSP 实施 6 年后 CRC 的发病率显著下降（P<0.01），但在女性中没有下降。如果癌症在 NCCSP 中诊断出，CRC 的 5 年生存率提高了 31.3%（P<0.05）。在 NCCSP 实施 6 年后，CRC 的发病率显著下降（P<0.01）。在计划外检测到癌症的患者死于 CRC 的风险比（HR）为 3.84（95% CI，3.36-4.40；P<0.001）。
